The system of "Kaifukuki Rehabilitation Ward (KRW)" where intensive
and comprehensive inpatient rehabilitation is carried out was created in
the year 2000 in Japan. The number of beds in "Kaifukuki Rehabilitation
Ward" are increasing up to more than 70,000.
Kaifukuki Rehabilitation Ward Association (KRWA) started in 2001 and became
a general incorporated association in 2007. Our aim is to enhance the quality
of rehabilitation in KRW and to provide Japanese people with the chance
of receiving well-arranged rehabilitation.
As our educational activities, many training workshops are held every year.
Ten articles of targets are set out for doctors, for nurses and careworkers,
for therapists, for socical workers, and for managerial nutritionists respectively.
Annual fact-finding survey is planned and those results or reports can
be seen in our web. Unfortunately these reports are written in Japanese
We have two KRWA journals. One covers many topics related to KRW written
in Japanese. The other is Japanese Journal of Comprehensive Rehabilitation
Science (JJCRS) that is our official English scientific journal. JJCRS
accepts not only KRW topics but also all topics about medical rehabilitation.
Let's make rehabilitation-rich society.
As one of the political solutions to rapidly growing ageing of the Japanese
society, the national insurance system introduced the Kaifukuki rehabilitation
ward (KRW) in 2000 and defined the KRW as the main system of inpatient
rehabilitation facility (IRF).
Kaifuku-ki represents the recovery or convalescent phase. Each patient
who still needs assistance in activities of daily living (ADLs) after treatment
of the specific disabling diseases in acute hospitals are transferred to
They include stroke, traumatic brain injury, spinal cord injury, acute
neurological diseases, hip fracture, multiple fractures, knee replacement,
hip replacement, and disuse syndrome after pneumonia and surgical procedure.
The KRW, comparable with IRFs in North America and Europe, includes coverage
of 60 to 180 day inpatient rehabilitation depending on the disease and
3 hours of rehabilitation per day including weekends.
To facilitate an interdisciplinary team approach, the KRW team provides
patients and their families with a comprehensive monthly rehabilitation
plan, including information about achieved goals, planned goals, and rehabilitative
approaches to achieve the goals; discharge planning; and social resources
necessary for a home discharge.
To ensure the quality of rehabilitation service, each KRW is required to
report several clinical indicators i.e., gains in ADL measures adjusted
to length of hospital stay as well as rates of medically unstable patients,
severely disabled patients and discharge home.
Since the Kaifukuki Rehabilitation Ward (KRW) system was introduced in
Japan in 2000, the KRW wards and beds have continuously increased in number
(Fig.1). At the time of establishment of KRW Association (KRWA) , the first
goal of the number of beds were 60,000 beds (50 beds for every 100,000
people) in Japan. The number of KRW beds exceeded 60,000 beds in 2010,
and 77,000 beds (60beds for every 100,000 people) are currently available
nationwide at the end of March 2016. The number 77,000 beds means 5% of
total inpatient beds in Japan.
Table. 1: The rate of becoming a member of KRWA (2016.3)
Fig.1: The number of KRW beds (2016.3)
1. Annual meeting of members
・A meeting of members is held in May every year.
・The board of directors of the Kaifukuki Rehabilitation Ward (KRW) deliberates an agenda involving fiscal year project reports, project planning, earnings reports, earnings estimates, election of officers, and other topics.
・Official’s term is 2 years.
・The board of directors of the KRW, who represent a medical care team, comprised of a physician, a nurse, a physical therapist, an occupational therapist, a speech therapist, a social worker, and a managerial nutritionist. The board will expand intense deliberations regarding the direction of KRW.
3. Committee Activities
(1) Insurance and survey committee
・Surveys regarding the KRW have been continuously conducted since 2001, maintaining a high response rate of approximately 60%. Insurance and survey committee has been involved in organizing these results, drafting policies, formulating commentaries on the reformation of the medical services payment system, putting forth necessary proposals, and other activities.
(2) General committee
・General committee have been constructing an intra-organizational crisis management system, strengthening disaster rehabilitation response, hosting and managing meetings with prefectural liaisons, and conducting other related activities.
(3) Editorial and public relations committee
・Editorial and public relations committee have been involved in the editing and publishing of hospital-related multidisciplinary KRW newsletters “Kaifukuki rehabilitation” four times a year.
(4) JJCRS committee
・JJCRS committee publishes the open access journal “Japanese Journal of Comprehensive Rehabilitation Science (JJCRS)”, which is the official scientific journal of KRW organization.
(5) Medical Safety committee
・Medical Safety committee have been investigating measures against easily